A direct response to circus artists’ questions about training during pregnancy.
It may seem odd that this is my first pregnancy and postpartum blog post, but let me back up and fill you in on why this makes perfect sense.
First, @cirquephysio aka Dr. Jen Crane is one of the first people who told me to take my pelvic health knowledge and practice online. So, it only seems right to provide some myth busting, women’s’ health info for her fierce following. First question:
Can we REALLY stretch during pregnancy?
Short answer. Yes. Work on active mobility and only stretch passively, as far as you can while keeping your pelvic floor and/or TrA engaged.
But you know that’s too easy right? So, some basic anatomy and reasoning behind the madness is below.
Of course, for other athletes, lifters, runners, and even from physical therapists’ and physicians’ view point, most answers would be, “of course, stretching is great!” And it is. In fact, moderate, relaxing, stretching has been shown to reduce incidences of preeclampsia, over a walking practice. But let’s be real, the mobility practice cirque artists have is far more intense than a “walking practice.” So let’s talk about specific considerations for stretching at the end of your range of motion and how pregnancy may change how your body responds. Stretching may also change how your pelvis feels and pelvic floor reacts during this time.
First, let’s separate mobility into two camps.
- Passive structural mobility or the amount of mobility your ligaments have. Ligaments attach bone to bone and are out of our conscious control.
- And dynamic mobility or the muscles that pass over your joints and allow for a conscious increase or decrease in range of motion through contraction and relaxation. These are also under control of our nervous system.
Both make up your overall mobility. Most of the time when stretching we are affecting the peripheral muscles: hip flexors, hamstrings, adductors, and even rectus abdominis or your 6 pack muscles. Many times, in contortion, you are also affecting ligaments or passive structures.
During pregnancy, there is hormonal influence on your ligaments and soft tissue that makes your joints more mobile – this is totally necessary to prepare your pelvis for growing and carrying a child and delivery. Embrace this as a good, healthy process! There is also hormonal influence on how our body repairs tissue, so let’s support the process from the beginning. You may notice you have increased muscle soreness, and fatigue during this time, as well. Hormones effect everything from pain perception, energy demands (you are growing a freaking spine!), and ability to remodel tissue. Read: greater rest times and built in “rebuilding time.” I know Jen has my back on this one.
With less structural support from the ligaments, the muscles around your pelvis are imperative to provide some more stability. Luckily, these deep muscles do just that; activate to stabilize before a movement or stretch of the overlying muscles, such as your hip flexors. However, due to the growing baby, this innate “turning on” of your transverse abdominis and pelvic floor can be inhibited. So, consciously engaging your deep transverse abdominis, pelvic floor, and even coordinating your breathing and diaphragm to exhale before a deep stretch provides your pelvis some additional stability. This will help to ensure your stretch targets the intended muscles; reducing stress on the ligaments of your pelvis.
You still with me?
Stretching during this time isn’t bad; it’s never a “yes” or “no” for a certain activity during pregnancy, but instead a “how” and “why.” Continuously, passively, stretching a muscle that overlays a more mobile joint may not be as effective or healthy for that joint, without the proper deep muscle engagement. This may cause some soreness to the pubic bone area, or where your low back and pelvis meet; your sacroiliac joints. These joints are intended to soften, but continued stress on these structures without muscular support can cause pain consistent with a sprain.
Without continued deep core (TrA, pelvic floor, multifidus and diaphragm) and glute training, your peripheral muscles, such as your hamstrings and hip flexors, may start to feel tighter during pregnancy. When muscles sense excessive boney movement (such as around your pelvis) they retract up like a rubber band. They are trying to hold shit together as a protective mechanism. So, in order to continue to gain mobility you need to provide deep muscular engagement first and change your focus to active mobility. Common muscles that may seem “tight” during pregnancy are the lats, pecs, hip flexors and hip external rotators, due to the normal biomechanical changes of pregnancy.
First, practice pre-contraction of the deep core to meet the needs of the movement.
Second, stretch only to the tension of your deep core engagement allows. When you lose engagement you are resting on your ligaments.
Third, switch your training priorities to active mobility and deep core coordination and endurance.
Fourth, THIS is not forever! Although it may feel like it. Respect that the amount of time hormonal changes endure postpartum is different for each person from four months after stopping breastfeeding, to a year postpartum. Care and intention now will make a difference long-term.
I’ve over simplified the systems of our static and dynamic stabilizers into three layers and how they change during pregnancy, so you can better understand what you are feeling and how mobility work may need to change.
1. Skeleton – more mobile due to hormonal ligamentous changes.
2. Deep core – needs more conscious activation to provide a stable foundation to gain mobility
3. Peripheral muscles – may be feeling tighter due to continued protective neuromuscular activation
So, if you are going to go into a deep hip extension stretch, see how far you can go while keeping your TrA engaged. Or if you are going to work on pancake splits, see how far you can go while keeping your pelvic floor engaged. It may not be as far as you want, but you can be assured you are stretching your peripheral muscles and not straining the joints of your pelvis that are just trying to do their job by helping you grow a human!